Archive for January, 2014

I often hear from clients during the first visit that they “were in therapy, but they didn’t get much out of it.” Now perhaps they were younger or were asked to go by their parents, it saddens me that people continue counseling despite any results. After the first visit, a teenager should be able to tell at least if there’s a level of comfort and trust with that therapist that would motivate that individual to make a second appointment. The person should also feel a little more hopeful upon leaving the first visit. So in essence, choose someone you feel connected to- after all, you will be sharing things about yourself that you may not be proud of!

Once a therapist has been chosen, the work begins changing maladaptive patterns of thinking or behaving. When a person comes to their sessions with things he/she would like to address, this guides our work with the assumption that this needs to be a priority. Last week, I had a 14 year old whip out her phone to look at three things she wanted to talk about! What motivation and maturity! As a result, I didn’t haven’t to fish for the areas of her life that were affecting her that week, she put it to the forefront of the session.

I also assign homework to my clients so they can feel empowered by having things to focus on rather than repeating patterns that weren’t working for them in the first place. Some clients follow through and some do not. But there’s a correlation for those who complete their homework- they reach their treatment goals faster.

I also ask my clients along the way how they feel therapy is going. This gives the client the opportunity to provide feedback and look at their level of commitment. It’s hard for a person to say they haven’t changed much if they haven’t done the suggested homework! So a level of accountability is addressed for their part of the therapy process. I would hope a client would be honest and tell me if they weren’t feeling that it was helping, but sometimes a direct question helps.

Lastly, as I have mentioned in my last blog, consistency. When a person participates in weekly sessions, the person is encouraged to share the issues of the week. Then options are discussed to best cope with the perceived problem, and then the following week, together we process any improvement or obstacles that came up. If two or three week go by, it is easy to forget what happened. Additionally, the person is unable to determine what efforts they did to remedy the problem and whether or not it helped. Especially when I am working with a teenager. Sometimes, they can’t even remember what they did over the weekend, let alone two weeks ago! So it’s better to do 10 sessions in ten weeks than 10 in 20 weeks (same cost, but greater result).

When it doubt, talk with your therapist. If you don’t feel you’re getting the results from therapy, but you like the person you’ve chosen, I encourage you to confront the therapist. Tell them exactly that and together you can discuss how best to get back on track. After you have given it more time, if you still feel dissatisfied, perhaps it’s time to pursue another avenue.

As always, thanks for taking the time to read my blog! Make it a great day!

People often ask me how long therapy will take. As with many questions in therapy, there are no simple black and white answers. The length of therapy depends on several factors. The first factor is the length of time that the symptoms have affected the client. Generally, the longer the person has experienced the symptom (anxiety or depression) or engaged in the behavior (cutting or drug abuse), the longer it takes to resolve the issue.

The second factor is the level of the client’s insight. The more aware the person is, the quicker the mood improves or the maladaptive behavior is unlearned. And it would make sense. First the person has to identify their mood or behavior before they can do anything about it. Then once we have discussed coping strategies, then the person can implement the change process once they recognize what’s going on.

The third factor has to do with any genetic disposition to the problem. If there’s a family history of depression or mental illness, then we are probably looking at a chemical imbalance stemming from hereditary issues.

This makes depression, for example, somewhat harder to work with than say a person who has situational depression.

Another factor deals with the client’s readiness and willingness to do the assigned homework necessary to implement change. Again, as a rule of thumb, the person who is ready to change and motivated to try a different approach to dealing with their problem, will need less time in therapy.

The severity of the problem also dictates the course of therapy. Severe depression or anxiety will be harder to treat than a mild case of the blues.

And lastly, the frequency and consistency of therapy is correlated with the duration of therapy. As with most goals, the more time you put in the faster you reach your goals. So weekly therapy will help to challenge the old ways of operating and decrease the time in my office.